目的:评价钬激光角膜热成形术(LTK)治疗轻度远视的疗效、安全性和并发症。方法:我们的研究对年龄>45岁的患者12例18只轻度远视眼行Ho:YAG激光LTK术治疗,能量密度65J/cm~2,平均随访2a。结果:患者年龄45～65(平均55.25±10.12)岁,术前屈光度+0.50～+2.25(平均+1.30±0.58)D,术前裸眼视力0.44±0.23,术后屈光度得以全部矫正,术后1mo,没有屈光回退,术后3mo,4眼屈光回退+0.25D。术后6mo,剩余屈光度在±0.50D和±1.00D以内的百分率分别为83%,89%,已矫屈光度和预矫屈光度符合率较好。之后存在屈光回退趋势,2a后屈光回退减缓。最佳视力出现在术后2wk内,以后裸眼视力开始回退。术前裸眼视力>1.0者为0,术后1mo,裸眼视力均较术前有非常显著的提高。术后3mo,裸眼视力达1.0者14眼(78%)。术后2a,裸眼视力达1.0者10眼(56%)。结论:Ho:YAG激光LTK术对轻度远视有效。临床观察证实此手术方法简单、安全,见效快以及并发症少等优点,为治疗轻度远视的手术方方法之一,但尚需长期观察其屈光稳定性。

AIM:To evaluate the safety.complication and effect of Ho:YAG laser thermokeratoplasty(LTK)for the treatment of mild hyperopia without astigmatism. METHODS:In the thesis,Ho:YAG LTK was used to treat mild hyperopia.18 eyes of 12 patients(aged>45 years) were treated and the energy density was 65J/cm~2. The average follow-up period was 2 years. RESULTS:The mean age of patients was 55.25±10.12 years(range:45-65 years).The preoperative hyperopic mean spherical equivalent refraction was + 1.30±0.58D (range:+ 0.50D to +2.25D).The preoperative uncorrected visual acuity(UCVA) was 0.44±0.23.All refractive error were corrected with no regression one month postoperatively.Only four eyes regressed + 0.25D three months postoperation.Six months later,the percentage of the residual refractive error less than±0.50D was 83% and less than±1.00D 89%.There was good coincidence ratio between the corrected refraction diopter and the attemped refraction diopter.And then there was a tendency of refractive regression.Two years later,the regression began to slow down.The best visual acuity appeared two weeks after operation,and then naked eye visual acuity began to regress.The preoperative UCVA equaled or more than 1.0 was 0.Three months postoperatively,the naked eye visual acuity increased very evidently.Three months postoperatively,UCVA equaled or more than 1.0 went to 78%(14 eyes).Two years later,UCVA equaled or more than 1.0 was 56%(10 eyes). CONCLUSION:Ho:YAG LTK is effective to treat simple low hyperopia.From clinical observation,it is evident that LTK operation is simple,safe,fast,and effective without short-term complication.LTK seems to be one of the promising procedures to treat mild hyperopia.We still need to observe its long time refraction stability.

中国上海市重点学科建设资助项目(No.S30205)~~